Paroxetine vs Amitriptyline: side-by-side comparison
Paroxetine (Selective serotonin reuptake inhibitor (SSRI)) and Amitriptyline (Tricyclic antidepressant (TCA)) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.
| Property | Paroxetine | Amitriptyline |
|---|---|---|
| Therapeutic class | Selective serotonin reuptake inhibitor (SSRI) | Tricyclic antidepressant (TCA) |
| CAS | 61869-08-7 | 50-48-6 |
| ATC | N06AB05 | N06AA09 |
| Molecular weight | 329.37 g/mol | 277.40 g/mol |
| Brands with this active ingredient | 1 | 1 |
What they share
Paroxetine and Amitriptyline share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.
Key differences
Paroxetine acts by a different mechanism than Amitriptyline, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.
Mechanisms compared
Paroxetine: Paroxetine selectively inhibits the serotonin reuptake transporter, increasing serotonin availability at the synapse. Amitriptyline: Amitriptyline inhibits the reuptake of serotonin and noradrenaline at central synapses, raising synaptic levels of both neurotransmitters.
Indications compared
Paroxetine: Paroxetine is approved for major depressive disorder, generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder, with regional variation. Amitriptyline: Amitriptyline is approved for major depressive disorder, but contemporary use is dominated by low-dose off-label indications: neuropathic pain, fibromyalgia, chronic tension headache, migraine prevention, irritable bowel…
Safety profile
Paroxetine: Common adverse effects include nausea, sexual dysfunction (more pronounced than with most SSRIs), weight gain, sleep disturbance, fatigue and anticholinergic symptoms. Amitriptyline: Common adverse effects reflect anticholinergic, antihistaminic and α1-blocking activity: dry mouth, constipation, urinary hesitancy, blurred vision, sedation, weight gain and orthostatic hypotension.
Frequently asked questions
Is Paroxetine better than Amitriptyline? ▾
Paroxetine and Amitriptyline are not "better or worse" — they treat different things. The sensible question is which fits your specific need.
Can Paroxetine and Amitriptyline be combined? ▾
Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.
Do they have the same side-effect profile? ▾
No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.
Products with Paroxetine
Products with Amitriptyline
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.